Development of strategies for screening, predicting, and diagnosing intrauterine HBV infection in infants born to HBsAg positive mothers.

This study aimed at developing strategies for screening, predicting, and diagnosing intrauterine HBV infection in infants born to HBsAg positive mothers. A total of 1,360 infants born to 1,355 HBsAg positive mothers were followed for 1 year. All newborn infants received active and passive immunization within 24 hr after birth. Maternal and infant blood samples were collected and tested for the status of serum HBsAg, HBeAg, and HBV DNA positivity. The accuracy of infant HBsAg positivity, HBV DNA positivity, HBsAg and HBV DNA double positivity, and HBsAg and/or HBV DNA positivity at birth in the diagnosis of intrauterine HBV infection was evaluated by receiver operating characteristic curve analysis. Of 1,360 infants, 145 tested positive for HBsAg and/or HBV DNA at birth. Twenty-one (1.5%) infants, who were diagnosed with intrauterine HBV infection, showed HBsAg positivity from birth to 7 and 12 months of age. Infant HBsAg positivity at birth had the highest sensitivity in predicting intrauterine HBV infection, while neonatal HBsAg and HBV DNA double positivity had the highest specificity. These findings suggest that infants, who were born to HBsAg positive mothers and were positive for both HBsAg and HBV DNA at birth, may be at a higher risk for intrauterine HBV infection. HBsAg positivity at birth may be a good marker for screening intrauterine HBV infection. Infant HBsAg positivity both at birth and 7 months of age may be used as a diagnostic criterion to simplify diagnostic procedures and improve diagnostic efficiency.

Clinical characteristics of fulminant hepatitis in pregnancy.

AIM: To investigate the clinical characteristics of fulminant hepatitis in pregnancy. METHODS: We compared and analyzed the etiology, clinical characteristics, and laboratory examinations of 25 cases of fulminant hepatitis in pregnancy and 30 cases of fulminant hepatitis not in pregnancy. RESULTS: HBV infection and chronic fulminant hepatitis were most common both in the pregnant and in the non-pregnant groups. Jaundice, digestive tract symptoms, increase of bilirubin and thrombinogen activity were the main manifestations. The incidence of hepatic encephalopathy (HE) and hepato-renal syndrome (HRS) was significantly different between the two groups. The incidence of preterm labor, dead fetus and neonatal asphyxia was high. CONCLUSION: Fulminant hepatitis is likely to occur in late pregnancy with more severe complications, which significantly influences maternity, perinatal fetus, and newborn.

Analyses of prognostic indices of chronic liver failure caused by hepatitis virus.

AIM: To analyze the related indices about the prognoses of chronic liver failure caused by hepatitis virus. METHODS: Retrospectively reviewed 320 cases of chronic liver failure caused by hepatitis viruses. An improved group and an ineffective group (IG) were made to compare and analyze their clinical manifestations, laboratory examination indices and complications. Logistic regression was also carried out. RESULTS: There were significant differences (P<0.05) between the improved group and the IG upon such indices as age, bilirubin, prothrombin time, albumin, alpha fetoprotein, the size of liver and complications (P<0.05). The regression formula was as follows: P = 1/(1+e(-y)) (y = 1.7262-0.0948X(1)+2.9846X(2)+0.6992X(3)+1.6019X(4)+ 2.0398X(5)). (Note: X(1)-Prothrombin activity; X(2)-digestive tract hemorrhage; X(3)-hepatic encephalopathy; X(4)-hepatorenal syndrome; X(5)-pulmonary infection.). CONCLUSION: Laboratory examination such as bilirubin, prothrombin time and alpha fetoprotein can be regarded as indices of the prognoses of chronic liver failure caused by hepatitis. Moreover, the regression equation can evaluate prognoses more comprehensively and direct our treatments.

[Relations of pre-pregnant weight and weight gain during pregnancy with pregnancy-induced hypertension and birth weight].

OBJECTIVE: To determine the influence of pre-pregnant body mass index (BMI) and weight gain during pregnancy on the occurrence of pregnancy-induced hypertension (PIH) and birth weight. METHODS: Pre-pregnant BMI and pregnancy weight gain of 769 mothers giving full-term birth to a single baby for the first time were measured and the pregnancy outcomes were followed up. RESULTS: (1) The incidence of PIH and fetal macrosomia was significantly higher in the overweight group than in the normal weight and underweight groups (P<0.01 and P<0.05, respectively), but differed little between the latter two groups (P>0.05). Underweight mothers were more likely to give birth to babies with low birth weight than the normal and overweight mothers (P<0.01), but the likelihood was similar between the latter two groups (P>0.05). (2) Irrespective of the pre-pregnant BMI, PIH and fetal macrosomia occurred at higher rates with the mothers with pregnancy weight gain no less than 18 kg (P<0.01), whereas low birth weight was significantly more likely with mothers with pregnancy weight gain less than 9 kg (P<0.01). (3) A weight gain during pregnancy over 18 kg gave rise to higher risk of PIH in normal and underweight mothers, but in overweight group, PIH occurred at a significantly higher rates when a weight gain more than 9 kg was recorded (P<0.05). The incidence of fetal macrosomia was significantly higher when the maternal weight gain exceeded 18 kg in the normal weight group (P<0.01), and low birth weight occurred more frequently in relation to a maternal weight gain less than 9 kg in the normal and underweight groups (P<0.01). CONCLUSION: Pre-pregnant BMI and weight gain during pregnancy can be important factors influencing the occurrence of PIH and the neonates' birth weight.

[Clinical analysis and treatment of hypospadias accompanied by associated anomalies in urogenital system].

OBJECTIVES: To study the occurrence of different anomalies associated with hypospadias and to instruct relevant treatment in clinical practice. METHODS: Three hundred and forty-one cases of hypospadias were investigated, all treated respectively corresponding to their specific anomalies. RESULTS: The morbidity of associated anomalies in cases of hypospadias was as high as 21.1%. Most of the anomaly cases were undescended testes and inguinal hernia, and the incidence of associated anomalies was related to the degree of hypospadias. CONCLUSIONS: Hypospadias is not just a local dysmorphic problem but rather a local manifestation of a systemic disease. It is necessary to take those associated anomalies as a systemic whole and attach enough importance to their clinical treatment.

[Papillary cystadenoma of the epididymis accompanied by testicular atrophy: one case report].

Papillary cystadenoma of the epididymis is a rare benign tumor, accounting for only 4 per cent of all epididymal tumors. Histologically, it can be confused with metastatic renal cell carcinoma. This extremely rare lesion may occur sporadically or as a manifestation of von Hippel-Lindau(VHL) disease. The present paper reported a case of papillary cystadenoma accompanied by testicular atrophy with no signs of VHL syndrome or infertility. To date, no similar case was reported in the literature. The tumor measured 5.0 cm x 4.0 cm x 4.0 cm and was located in the right epididymis. Histopathologic examination of a surgically removed specimen indicated a primary papillary cystadenoma. Histomorphologically, these tumors are characterized by cysts with colloid-like contents and papillary formations of light epithelium. Since metastatic renal cell carcinoma may be histologically similar to papillary cystadenoma, the importance of long-term urologic follow-up for possible presentation of renal cell carcinoma is discussed.